SCHA-LA

some quick notes on the drop in hate crimes report in today’s LA Times

Posted in Uncategorized by SCHA-LA on November 20, 2009

Here are some quick notes – I need to think these things through (after, ironically, tonight’s DOR) – on an article in today’s LA Times: LA County Hate Crimes Drop 4%

  1. It would seem that, since Prop 8 was upheld, that the more “logical” expectation (not that this sort of violence is logical) would be an increase in gay-on-straight violence, or retaliation. I believe that the question is hidden, but unanswered, in the article: if the anti-gay faction won Prop 8, why the increase in anti-gay violence? This question is especially interesting considering that the article hypothesizes that Obama winning the presidency  is related to a decrease in race-based crimes. To look at these to theories as analogous,
    1. “anti-gay” legislative victory equals an INCREASE in anti-LGBT hate crimes
    2. “pro-African-American” victory equals a DECREASE in racial hate crimes
    3. As an aside to that which isn’t mentioned at all, it does appear that there has been a public uptick of outspoken, public racism in the country, but that has not shown up as hate crimes, rhetoric aside. and I believe that this is as true in LGBT circles – at least in California – as in non-LGBT populations. (see link at end of this post)
  1. The article refers to hate crimes against LGBT people. I wonder why, later in the article, the author refers to “sexual-orientation hate crimes” – seemingly implying that trans- is a sexual orientation. One might presume, according to the limited data that is collected on transpeople, that most transpeople identify as heterosexual. So in general, an  anti-trans hate crimes should not be classified as a sexual orientation hate crime, but rather as a gender-identity or gender-presentation (transphobic)  hate crime. How come there is no discussion of that in the article? Further, were there anti-lesbian hate crimes? Were there anti-bisexual hate crimes? I think people might be interested to know who is actually getting hurt, abused, or killed – and usually over-killed.
  2. With regard to the “LGBT” victims of hate crimes: are all of them white? It seems to be the unspoken message when we read about race-based hate crimes going down as LGBT hate crimes rise. I supposed I’d like to know if “sexual orientation” hate crimes against LGBT people of color went down as they did with the non-LGBT population, or, if that isn’t the case, why not?  When a person of color is the victim of a hate crime, and that hate crime was due to their sexual orientation or gender identity, where does that get filed? At least with transwomen, almost ALL of the reported cases are in young transwomen of color (cite: rememberingourdead.org)
  3. If we assume that the perpetrator (rather than the victim) of a hate crime is the guilty party, why do we not see any stories about the perpetrators? This article only points out the victims. The perpetrators are shrouded. What demographics do they represent? Is that not the more newsworthy story, since one can imagine that it is easier to strategize community-based (or even law-enforcement-based) interventions tailored to the people who are committing these hate crimes, rather than making assumptions on who may be a victim? That actually seems to be exactly what the perpetrators do.  An example: Why do we know the name Rosa Parks but we don’t know the name James F. Blake? Now, I’m not trying to call Rosa Parks a victim – though she certainly was a victim of racism & police brutality. Instead I’m trying to highlight how a white person can avoid looking at the historical behaviors of white folks’ while still honoring the memory of Rosa Parks. I can see Rosa as a part of our historical fabric, but not the man who called the cops on her.  To me, that is the insidious under-girding of racism, and it exists today and is exemplified by the secrecy about who is committing these hate crimes, and the over-emphasis on the victims, and especially the brutality with which they tend to die.
  4. The recent murder of Paulina Ibarra in East Hollywood, and the fact that there is still a person of interest out there somewhere, might have been relevant to the article.
  5. a quick addendum: please read Jasmyne Cannick’s post on this report as well.

sign-on letter to preserve AIDS Drug Assistance Program in CA

Posted in CA Budget by SCHA-LA on November 20, 2009
All,I know that this will come as a surprise to a lot of you, but we haven’t had much of a chance to talk with the community about the forthcoming expected ADAP crisis in California yet. We have been pulling together materials and developing a brief so that we could alert the community with as much information as possible. Part of our response includes a planning community sign-on letter for the end of the month.

However, not all plans work according to our schedules and we have just been alerted that we need to produce the community sign-on letter and need to have as many organizations as possible sign on IMMEDIATELY.

I hope you will understand the urgency of this issue and the important of adding your name to the chorus now.

Thanks,

Craig A. Vincent-Jones
Executive Director
Los Angeles County Commission on HIV
3530 Wilshire Boulevard, Suite 1140
Los Angeles, CA 90010

TEL 213.639.6714
FAX 213.637.4748
EML cvincent-jones@lachiv.org
WEB www.hivcommission-la.info

Please read the sign-on letter below. At this point, we’re only signing organizations/groups. Have them confirm their names with Craig Vincent Jones (cvincent-jones@lachiv.org or Dawn McClendon (dmcclendon@lachiv.org). PLEASE DO THIS AS QUICKLY AS POSSIBLE. TIME IS OF THE
ESSENCE.

November 19, 2009

The Honorable Arnold Schwarzenegger
Governor of California
State Capitol Building
Sacramento, California 95814

RE: Full Funding for the AIDS Drug Assistance Program

Dear Governor Schwarzenegger:

We are writing to demand full funding for California’s AIDS Drug Assistance Program (ADAP) in FY 2010-2011.

ADAP is the cornerstone of California’s public health effort to fight HIV/AIDS. Failure to fully fund the program will leave thousands of Californians at risk for more severe illness and even death. Underfunding could also cause a public health disaster and significantly limit the state’s ability to prevent new HIV infections. Reductions in ADAP will cost the state millions more in future health care dollars than any savings realized in the near term. Cuts in ADAP will also increase burdens on our already-taxed emergency rooms and other “safety net” providers who are not equipped to deal effectively with HIV and AIDS.

More than 34,000 low-income uninsured and underinsured Californians depend on ADAP for life-saving medications. Reduction in ADAP services will lead to advanced HIV disease, increased co-morbidities and even premature death for Californians living with HIV.

Medications provided by ADAP can help prevent transmission of HIV. People on effective treatment regimens can reduce their viral load (the amount of HIV detected in the blood) to undetectable levels which makes them less likely to transmit the virus to others. For every new HIV infection we prevent, the state saves an estimated $600,000
in lifetime treatment costs.

California cut essential life-saving state HIV/AIDS programs by some $85 million last year. The cuts vastly reduced the state’s capacity to prevent, treat and serve the estimated 160,000 Californians living with HIV/AIDS. Any cuts to ADAP will leave many living with HIV no access to life-saving drugs and Californians at risk vulnerable to a renewed spread of the virus.’

We urge you to show leadership in your FY 2010 -2011 budget proposal by fully funding ADAP. People wlth HIV and people at risk for HIV must not be asked to pay for state budget cuts with their health and their lives.

Sincerely,

AIDS Emergency Fund
AIDS Legal Referral Panel
AIDS Project Los Angeles
AIDS Service Center
American Academy of HIV Medicine, California Chapter
Asian and Pacific Islander Wellness Center
Behavioral Health Services, Inc.
Black Coalition on AIDS
California Conference of Local AIDS Directors
California Positive Women’s Network
Center for AIDS Research, Educations, and Services of Sacramento
Charles Drew University of Medicine and Science HIV/AIDS Education and Outreach Projects
City of Los Angeles, AIDS Coordinator’s Office
City of Pasadena Public Health Department
Common Ground-The Westside Community Center
County of Los Angeles, Department of Public Health, Office of AIDS Programs and Policy
Desert AIDS Project
Face to Face/Sonoma County AIDS Network
Foothill AIDS Project
HIV ACCESS   Alameda County, CA
HIV Health Services Planning Council-San Francisco
HIV Health Services Planning Council-Sacramento
Immune Enhancement Project
Los Angeles County HIV Drug & Alcohol Task Force
Los Angeles County HIV Mental Health Task Force
Los Angeles County Commission on HIV
Leland House, Catholic Charities CYO
Lutheran Social Services of Northern California
Martin Luther King/Multi-Service Ambulatory Care Center – OASIS Clinic
Mental Health America of San Diego County
North County Health Services, Inc.
Northeast Valley Health Corporation
Positive Resource Center
Project Inform
San Francisco AIDS Foundation
San Francisco Community Clinic Consortium
Sonoma County Commission on AIDS
Sonoma County People with AIDS Advocacy Committee/Reconnect Action Committee
STOP AIDS
Strong Consulting
Van Ness Recovery House
Women Organized to Respond to Life-Threatening Disease

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HIV Commission annual meeting twitter feed

Posted in Uncategorized by SCHA-LA on November 16, 2009

I had every intention of taking notes at the meeting, but instead decided to twitter and rely on handouts. Here is the twitter feed: http://twitter.com/SCHA_losangeles (obviously from newest to oldest) and the slides and some thought shall follow.

Mario responds

Posted in Uncategorized by SCHA-LA on November 12, 2009

Mario responds with:

  • Background & context: on occasion John Freeman facilitates a conversation between Commission leadership & OAPP because there are issues (including MOU, reference about my comments at last COH meeting).
  • Mario asked Dr Green to share his perspective because of his unique position in terms of how the 2 bodies are working together.  In short order there will be 33 less staff at OAPP to help us address our charge. See “freeman effect”.
  • Balance:
    • consumer need (who are not shy about telling us what is not working at provider level)
    • provider realities (asking providers to do more with less). We go through waves in which agencies contracted portfolios. 18 months ago this summer, more in the near future. Sense that providers are really struggling to meet some of the basic contractual deliverables we have laid out. There is an incongruence between our perspectives and their abilities
    • planning council & standards of care: there is debate. Is what we put into print the gold standard or the minimum standard? COH has the higher possible standard, OAPP looking at minimum standards
    • financial realities
  • @ last COH I said gap bet SOC and Service Provider realities is growing. There are stds in place which we can not afford or deliver. Our TMP expectations are 4 viral loads/client/year. Natil guidelines say 2 if you’re stable.  Just got rid of medical nutrition therapy in our county and now we expect our medical providers to do an nutritional eval on all of our clients every year?
  • Let’s assume best case scenario that adap is flat-funded. We need $32mill to meet everyone’s asap need? What is going to go, or do we just expect providers to just meet higher standards?
  • Coh has done outstanding job developing standards, but they have not done a good job in establishing standards in developing standards in relationship to funding.
  • Coh should focus on ensuring that the overall system is effective but don’t micromanage or repeat exercises that have been done. Let medical directors guide medical SOC for this county.
  • Dr green recently did a survey of all oapp chiefs. In atypical month how many hours do you spend responding to coh requests/activities  182 hours a month .  so when I say that oapp can not continue with the sustained demand of our time, this is what I’m talking about.
  • There is a need for us as a planning body in the NEXT EW WEEKS about what our contingency plan is when/if ADAP is unable to meet need. How much Part A/B resources are we willing to divert? $10m? $15m? what services as a system are we prepared to do without to meet the hiv rx needs that are going to be growing and not going away?
  • STD programs: many opptys for efficiencies. NAT testing – 2 high volume sites: AHF/GLC – 1/250 test positive. People who are seroconverting and highly infectious.
  • What gives the system the greatest bang for the buck. The commission needs to have these conversations.
  • My goal reminds me that if coh, given all the wonderful work you’ve doe, did very little above your core duties you’d still be head & shoulders above most planning groups in America. My challenge is: let’s be strategic  and thoughtful about what demands we place on one another to meet the consumer need. And if consumer need is really a driver – at the end of the day (of a half or full day meeting) did what ewe do benefit a single hiv+ person?

brainstorming session

Posted in hiv by SCHA-LA on November 12, 2009

What are the issues/challenges?

  • Is there a notion that planning isn’t important or that it’s going to go away?
    • Craig: When there is a discussion about streamlining, especially when economic hardship is @ the root of that conversation, Craig’s comment addressed that we don’t streamline it so much that  it’s not substantive any longer. The planning process doesn’t yield anything significant and makes the planning process worthless
  • Re Julie’s presentation on Universal Healthcare / Healthcare Reform (HCR) – there is the medical care coordination component which we are working on currently. That will be able to continue regardless of what happens @ the federal level. What about ADAP and immediate action that needs to take place? Don’t  want to be put on a waiting list
    • at the core is our ability to provide medication
  • Mickie: at the last mtg we tabled until today an item which isn’t on the agenda: a stmt was made by Mario that it is too great a burden to follow all the directives that the COH gives and that all the Standards of Care might not be implemented. Subtext: comprehensive care plan. That was a huge issue. The room exploded but it was put off b/c it was said @ the end of the meeting and it appears to have vanished.
  • Whitney: We strive for constructive tension but we have arrived at destructive tension. Can we call out some of the respective trust issues?
  • Carrie: when I look @ the list of partners that is on the agenda – is this an exhaustive list or are we missing potential partners we could leverage? and
  • Prison parolees – what does that mean in terms of the state of health for LAC?
  • Carol:  partnerships & collaborations. 2 yrs ago, CDC was here to discuss collaborations. This was before the current economic problems. This has not only affected HIV, but also STD, TB, HCV … when do we start to collaborate? We’re reaching out to the same populations.
  • Sharon: post-incarcerated & ADAP. Underserved pops are usually the most incarcerated. To not ensure that they don’t have rx when they go back out into the population is tantamount to criminal. Also
  • Why so long for the HOPWA wait? Criminal background checks and tendency to underserve these communities.
  • Robert: how do we educate & empower the people using out services in addition to people who could potentially be clients or who may never seroconvert
  • Ted: remember walking into an ASO and applying for ADAP 23 years ago. She said that “it’s over. You have to either die or wait for someone else to go to get on the list”. She produced a pamphlet and said “you have to call the governor and you have to get involved”. The people who laid down the groundwork must be turning over in their grave. We think our animals much better than we treat ourselves right now. We can not go on like this. Every day I am … getting someone to listen because we need to take our government back. It is unacceptable that pharma aren’t present for this. They’re sitting pretty. they have tax shelters in the cayman islands. They need to be here to hear these stories time and time again. They need to step up in times of crisis and relieve some of their profits so we can have life.
  • 5% of pop with syphilis are responsible for 50% of new infections.
  • Define “network” and “collaboration” – what are we walking about? What do we mean by that?
  • Medicare reductions
  • How do we keep quality high with reduced resources and less staff? How do we keep a solid infrastructure?
  • Bone-weary of the rancor between COH and OAP and there is plenty of blame on both sides. Stop the needless posturing, wheel-spinning and accusations.
  • Communities are made up of people, not agencies and clients.
  • Alternative economies build community, enable us to care for and about other people in the community because the health of the entire community is keeping everything going. Also, keep people (“clients”) from skills atrophy as everything is being done by a provider
  • Look at countries that have very little but do great work – examples.
  • Carrie:  I don’t think we’re walking away with very much.  … my issue is that our focus – should it be on funding on services on engagement in care. If it is those 3 lenses, then when are we going to have the opportunity to begin to address this and when are we going to think about the issue of civic engagement. We had an entire state that simply sat by and watched budgets be cut and funding be cut and there was no outcry.  Can we start that genuine discussion now or do we wait until December.

 

  1. 1. Is planning going to go away?
  2. 2. What do we do about ADAP?
  3. 3. Is burden of directives too great?
  4. 4. Are Standards of Care being implemented?
  5. 5. Concrete (small) steps toward building confidence and trust
  6. 6. Are we missing potential partners?
  7. 7. Collaborations. When do we start?
  8. 8. Streamlining HOPWA and criminal background checks
  9. 9. Educating and empowering people about how to access services, and which services – what they have available outside of public sphere
  10. 10. keep clients as independent as possible for as long as possible
  11. 11. take government back
  12. 12. pharmaceutical companies need to give back.
  13. Better understanding of planning for services that OAPP implements
  14. Can we plan over a longer period of time than a single year? Look with more long-term
  15. STD and HIV must work together.
  16. Planning that can be realistically implemented
  17. Medicare reductions
  18. Undocumented people paying for medical insurance
  19. Moving people to medi-cal
  20. 20. How do we keep quality high with reduced resources and less staff?
  21. Improvement in tone of dialogue.
  22. Collaboration is not about getting money from other pies
  23. Collaboration is about people
  24. Alternative economies (time banks, bartering etc)
  25. Leveraging policy and political resources
  26. Relationship is critical
  27. Civic engagement (people outside of this room)

 

ESPECIALLY issues between OAPP and the HIV Commission. Can we discuss these through this lens?

 

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HIV-impacted LA: 2009 (what the Commission did this year)

Posted in hiv by SCHA-LA on November 12, 2009

Carla Bailey and Tony Braswell Co-Chairs presentation on Accomplishments of the LAC Commission on HIV:

“…. But we stand” [Carla Bailey]

Joint Public Policy

  • worked with uthor to revise language.secure county support for AB 1045
  • participated in planning of National HI Strategy, genera ed policy briefs
  • Developed Commission’s 2010 policy agenda
  • maintained policy docket, monitoring 30+ pieces of legislation
  • collaboration to promote/support re-authorization of Ryan White
  • hosted/led statewide ADAP Summit
  • building momentum for HIV in adult film industry
  • opposition to the state budget (organized rallies in LA and Sacramento)
  • helped prevent cuts to ADAP and surveillance, maintain separate allocation to other areas of the state.

Priorities & Planning

  • spent 10 months in priority and allocation setting
  • created first Service Utilization and Needs Assessment Report
  • established new methodology and specific SPA 1 allocations & thresholds
  • in collaboation with CHIPTS applied for Robert Wood Johnson’s Public Heath Serices and System Research Intitiative
  • Designated aging HIV population a new “special population”

Standards of Care

  • Developed 3 new standards: ADAP enrollment; Drug Reimbursement/Local Phrmacy Program; and Case Management, Housing
  • Revised standards for: benefits specialty; direct emergency financial assistance
  • hospice/skilled nursing
  • language/interpretation services
  • medical outpatient/specialty
  • residential, transitional
  • drafted 3 special populations guidelines: African-Americans, homeless, Latin@s
  • finalized new continuum of care
  • secured HRSA-funded Medical Care Coordination consultant and created transition planning process
  • submitted oral health comparative effectiveness proposal for NIH stimulus funding; proposal made it to final stage of formal evaluation comments

Operations

  • collaboration with Latino Task Force on membership recruitment, reaching Latin@ membership targets
  • developed new membership and orientation training plans
  • maintained compliance with HRSA membership requirements
  • filled majority of remaining vacancies
  • continued Consumer Caucus activities
  • HIV Service Round Table meetings with HIV+ folks in SPAs 3 & 8; developed tool to monitor consumer input from the events
  • developed a consumer mobilization database
  • held consumer Empowerment and Mobilization training

 

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Save City of LA AIDS Coordinators Office

Posted in hiv by SCHA-LA on November 2, 2009

Agenda Special PH 110409 SOCOD Fact Sheet CFS 101309

COD Fact Sheet CFS 101309

COD Special PH 2009 DOD Consolidation flyer11-04-09 shreddedribbonflyer-cityaidscoord

As we know, the State Office of AIDS has been virtually stripped of State funding for HIV-related services. Please think about this “consolidation” and consider the potential impact on people affected by HIV in the City of Los Angeles should the City AIDS Coordinator’s Office get subsumed into a larger body.

20 YEARS AFTER MAYOR BRADLEY CREATED THE AIDS COORDINATORS OFFICE, IT WOULD CEASE TO EXIST AS OF THE “CONSOLIDATION”

Call for Support for the Continued Existence

of the Commission on Disability and the Department on Disability

WHAT:

The City of Los Angeles Department on Disability (DOD) and the Commission on Disability (COD) is threatened in the City’s budget process, again. Los Angeles City Council is considering ELIMINATING the DOD and COD as they now exist, and merging their roles and functions into the Human Services Department, which is an amalgamation of three [former] City Departments – Commission on the Status of Women; Commission for Children, Youth and their Families; and the Human Relations Commission. Each year, DOD serves over 15,000 people with disabilities (including persons living with HIV/AIDS), and provides technical assistance to hundreds of organizations (private and public), as well as to local and international governments.

EFFECT:

“MARGINAL COST SAVINGS” from cutbacks and merging of the Department will seriously impact our ability to provide opportunities for employment, health services, and all other essential resources for persons with disabilities and other marginalized populations; and it will curtail our ability to obtain both government and private funding for the benefit of all residents with disabilities.

NEED:

“WHAT YOU CAN DO” – Express your views “in-person” by contacting the offices of the Mayor at (213) 978-0600, or Mayor@LACity.org; or contact City Councilmembers (see below or go to the City’s website at http://www.LACity.org for contact information). MOST IMPORTANT: Attend the City’s Council Meetings to voice your support during Public Testimony.

THESE ARE CRITICAL ISSUES, SO PLEASE LET YOUR VOICE BE HEARD IMMEDIATELY!

WHERE:

Los Angeles City Hall

Board of Public Works

200 North Spring Street, Room 360,

Los Angeles

WHEN:

Wednesday, November 4th at 1:00pm

Each year, DOD services over 15,000 people with disabilities (including persons living with HIV/AIDS, and the hard-of-hearing and deaf communities), and provides technical assistance to hundreds of organizations (private and public), as well as to local and international governments. If consolidated, it will eliminate their ability to function as they now exist!

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